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目的:评价鼻咽癌中国2008分期、UICC 2002及2009分期系统对预后的预测价值,为鼻咽癌分期系统的进一步修订提供依据。方法:收集2004-10-01-2005-10-31中山大学肿瘤医院收治的869例病理确诊初治无转移且有鼻咽颈部MR资料的鼻咽癌患者,按照鼻咽癌中国2008分期、UICC 2002及2009分期系统重新进行分期,比较3种分期的情况及预后预测价值。结果:在临床分期方面,UICC 2009(χ2=66.042,P<0.001)及2002(χ2=66.582,P<0.001)能更好地预测预后。在T分期方面,UICC 2009分期对局部复发的预测价值优于UICC 2002及2008分期(χ2=13.794,P=0.003),将鼻窦、颅底骨质侵犯合并为T2后,无复发生存曲线能更好地分开;在N分期方面,3种分期各有优势。结论:UICC 2009分期标准能更好地预测预后,但仍存在不足。
Objective: To evaluate the prognostic value of nasopharyngeal carcinoma staging 2008 in China and UICC 2002 and 2009 staging system, and to provide evidence for further revision of nasopharyngeal carcinoma staging system. Methods: Totally 869 cases of nasopharyngeal carcinoma with pathologically confirmed primary MR without nasopharyngeal neck MR data were collected from Cancer Center of Sun Yat-sen University from October 2004 to January 2005 in accordance with the 2008 staging of nasopharyngeal carcinoma in China. UICC 2002 and 2009 staging system re-staging, compared the situation of the three staging and prognostic value. Results: UICC 2009 (χ2 = 66.042, P <0.001) and 2002 (χ2 = 66.582, P <0.001) were more predictive of prognosis in clinical stage. In terms of T staging, the predictive value of UICC 2009 staging for local recurrence was superior to UICC 2002 and 2008 staging (χ2 = 13.794, P = 0.003). The recurrence-free survival curve was more consistent with sinus and skull base bone invasion as T2 Good separation; in the staging of N, the three staging have their own advantages. Conclusion: UICC 2009 staging can better predict the prognosis, but there are still some shortcomings.